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Research Letter
Less Is More
September 2017

Association Between Contemporary Trends in Inferior Vena Cava Filter Placement and the 2010 US Food and Drug Administration Advisory

Author Affiliations
  • 1Department of Internal Medicine, Temple University Hospital, Philadelphia, Pennsylvania
  • 2Department of Cardiovascular Diseases, Temple University Hospital, Philadelphia, Pennsylvania
  • 3Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
  • 4Department of Clinical Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania
JAMA Intern Med. 2017;177(9):1373-1374. doi:10.1001/jamainternmed.2017.2719

The effectiveness of inferior vena cava filter (IVCF) insertion in reducing venous thromboembolism (VTE)-associated morbidity and mortality is uncertain.1 Nevertheless, IVCF placement rates in the United States have been rapidly increasing and are 25-fold higher than in Europe.1 Prompted by the report by Nicholson et al2 in this journal of high prevalence of fracture and embolization, with potentially life-threatening sequelae of the Bard Recovery and Bard G2 IVC filters, the US Food and Drug Administration (FDA) issued a device safety warning on August 9, 2010, after reviewing 921 adverse events (ie, device migration, fracture, thrombosis) reported over a 5-year period.3 We sought to assess the nationwide utilization rates of IVCF placement in the United States and the impact of this FDA advisory. We also evaluated VTE-related hospitalization rates during the same period to determine whether any change in IVCF utilization could be accounted for by changes in VTE-related hospitalizations. Temple University waived the requirement for institutional review board approval.

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